Palliative Care: Options not absolutes

Generally speaking, we live in a society that is uncomfortable talking about suffering and death. The reality though, is that both are a part of life. It is important that medical and clinical staff, along with chronically ill patients and their families understand that it must be acknowledged on the way to an open dialogue about palliative care options.

The term “palliative care” is often misunderstood, and often confused with hospice care. However, palliative care services offer a wide array of options that do not center on death. While death might ultimately be a part of the conversation, the broader scope of palliative care is for anyone with a serious, complex or chronic illness.

The goal of palliative care is to prevent and relieve suffering. Its purpose is to support the best possible quality of life for patients and their families, regardless of the stage of the disease or the need for other therapies. Additionally, it helps guide and assist the patient and family in making decisions that will help them achieve their goals—improving their quality of life and often extending it as well.

In a well-known study published in 1996, known as the SUPPORT study, it was reported that Americans often died in pain, and their wishes for how they’d like to live out the remainder of their lives were either unknown or ignored. It raised an important question that is the basis for palliative care: What are a patient’s desires and wishes?

“Quite often we get so hung up on what we can do for someone medically that we don’t ask who the people are and what they would really want. And that, I feel, is the more important question,” says Kathy Kennel, NP, a Palliative Care coordinator at Tucson Medical Center.

Kennel receives many letters from patients and their families who have benefitted from Palliative Care. One such letter reads, “As a daughter, we didn’t know which direction to go, and you helped clarify what would be important for our mom. Thank you for asking about who our mom is.”

The benefits of this approach extend well beyond the individual patient. In an excerpt from his recent article entitled Palliative Care: Improving Care for Chronic Illness, Dr. Scott Lake states:

“When asked, most Americans say they would prefer to die at home, yet the majority of us die in hospitals and other institutions, often in pain. It would seem logical that the more health care a patient gets, the better that patient’s care would be, but for those nearing the end of life, this is not always the case. In 2009, Medicare spent an estimated $143 billion caring for people in their last year (25% of all Medicare spending). It is estimated that 20-30% of this care had no meaningful impact on the outcome of the illness; to the contrary, such spending and extensive treatment can too easily decrease quality of life during this period, and thus, the quality of death.”

Although the practice of palliative care has really picked up momentum in the last 5-10 years, there are still a lot of myths and confusion surrounding it. At Tucson Medical Center, actively offering Palliative Care options and discussions to our patients and their families from the onset of symptoms from a serious, life-limiting disease, is in alignment with TMC’s mission, vision and values. As such, it is important that the community is able to truly understand what it is.

Seriously ill patients should know there is a medical specialty focused on meeting their unique needs. TMC’s palliative care nurse practitioner can work with a primary care physician to provide treatment of the pain, discomfort, and stress while the patient is receiving other treatments at all stages of an illness.

For anyone who wishes to learn more about palliative care programs and options, TMC will be hosting a panel discussion on Nov. 14 at the El Dorado Health Campus from 10 to 11:30 a.m. Join Larry Lincoln, MD, Kathy Kennel, NP, and Mary Steele, RN, to learn what Palliative Care is all about, when to access this service, and the future of Palliative Care.

To sign up, contact Joanne at Health Living Connections at (520) 324-1960.

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About TMC

Tucson Medical Center, licensed at more than 600 beds, has been Tucson’s locally governed nonprofit regional hospital for more than 70 years.

TMC is Southern Arizona’s leading provider for emergency care and pediatric care (including Tucson’s first Pediatric Emergency Department), with top-notch intensive care units for adults, children and newborns.